People who survive serious injuries caused by burn or trauma face a long and difficult recovery period riddled with many potentially fatal complications along the way. Researchers yearn to understand the critical features that can tip the delicate balance of a severely injured body toward recovery, and those factors that cause people to die from such injuries  sometimes weeks after the injury occurred. Identifying those factors could help guide physicians in choosing the best treatment in response to a life-threatening injury.

To begin to identify the scientific underpinnings of the body's response to burn and trauma, the National Institute of General Medical Sciences has provided a $6.7 million "glue grant" (for the first year of funding) to a consortium of clinical and basic scientists who will attempt to tease apart the complex set of events culminating in the immune system's reaction to a traumatic injury. NIGMS anticipates spending a projected total of $37 million on the project over the course of five years.

Researchers know that one common thread in a body's reaction to a traumatic injury is inflammation. This seemingly harmless process--the reason an annoying mosquito bite itches so much or why a sore throat aches  is a necessary defense mechanism that can also turn into a deadly, often fatal cascade of events. Excessive inflammation can lead to the body-wide infection called sepsis, a common, fatal outcome of injury caused by burns or trauma.

"For some research, the intellectual and material resources available to individual laboratories, or even to small groupings of labs, are simply not enough to adequately attack the problem. Glue grants provide an opportunity to marshal the resources needed," said Dr. Marvin Cassman, director of NIGMS.

The inflammation glue grant project brings together a large group of scientists from leading academic medical centers across the country. Leading the project is Dr. Ronald G. Tompkins, a surgeon and biomedical engineer at Massachusetts General Hospital.

"Hundreds of thousands of Americans die from injury and millions more are hospitalized each year, at societal costs of more than $200 billion annually," said Tompkins. "Traditional research approaches have not yielded the medical breakthroughs needed for further significant medical advances in this area."

The researchers seek to study the complex interplay between the acute events that take place after a serious injury and how the body's immune system responds. An important goal of the project will be to develop standard operating procedures, called SOPs, for burn and trauma patients. Establishing such standards will encourage collaborations across multiple trauma centers nationwide. Currently, physicians have a limited number of standards to follow in the immediate care of burn and trauma patients.

According to Tompkins, the glue grant approach provides a unique opportunity to understand the body's molecular reactions to injury, including inflammation.

"From this understanding of how the body controls inflammation, we expect to be able to not only increase the likelihood of survival, but also to favorably impact length of hospitalization and cost of treatment, as well as quality of life," Tompkins said.
Ultimately, the research should help scientists develop ways to predict patient outcomes based upon certain molecular measurements, such as genetic fingerprints.

The team will be multifaceted  consisting of burn and trauma surgeons, critical care physicians, geneticists, cell biologists, physiologists, biostatisticians, mathematical modelers, bioinformatics specialists, and biomedical engineers. The arrangement should provide for a multi-pronged attack on the study of burn and trauma injury, a critical public health problem. Research results obtained by consortium members will be shared promptly and freely with the broader trauma and burn injury research scientific community.

NIGMS originally conceived of the large-scale glue grants following consultations with leaders in the scientific community who emphasized the importance of confronting intractable biological problems with the expertise and input of large, multifaceted groups of scientists.

The first glue grant was awarded last year to Dr. Alfred G. Gilman, a pharmacologist at the University of Texas Southwestern Medical Center, who won the Nobel Prize in 1994 for work on signaling molecules called G proteins.

Joining forces with Tompkins and his team are researchers from several institutions, including Harborview Medical Center, University of Washington; the University of Texas, Houston Health Sciences Center; the University of Colorado Health Sciences Center; Northwestern University; the University of Florida College of Medicine; Stanford University; Washington University; and the University of Alabama at Birmingham.

Please mention support for this work from the National Institute of General Medical Sciences (NIGMS), a component of the National Institutes of Health that supports basic biomedical research. Please fax clips to (301) 402-0224.

Contacts
For comment on the glue grant program, call Alison Davis in the NIGMS Office of Communications and Public Liaison at (908) 735-7207 to arrange an interview with NIGMS director Dr. Marvin Cassman.

For comment on the inflammation glue grant, call Susan McGreevey at (617) 724-2764 to arrange an interview with Dr. Ronald G. Tompkins.